San Diego’s Top Vein Specialists

Dr. Nisha Bunke and Dr. Helane Fronek, La Jolla Vein Care's vein specialists

Dr. Nisha Bunke and Dr. Helane Fronek, La Jolla Vein Care’s vein specialists

Check out La Jolla Vein Care’s Dr. Bunke and Dr. Fronek in the October issue of San Diego Magazine, which is the Top Doctor’s Issue. The article highlights the doctors expertise, specialized training, and diagnostic and innovative treatment technology that is offered at La Jolla Vein Care.



Recognized on 13 October, World Thrombosis Day (WTD) focuses attention on the often overlooked and misunderstood disease of thrombosis. With hundreds of educational events in countries around the world, WTD and its partners place a global spotlight on thrombosis as an urgent and growing health problem.

Thrombosis is the formation of potentially deadly blood clots in the artery (arterial thrombosis) or vein (venous thrombosis). Once formed, a clot can slow or block normal blood flow, and even break loose and travel to an organ. This can result in significant injury, including heart attack, stroke and venous thromboembolism – the top three cardiovascular killers.

At La Jolla Vein Care, we specialize in ultrasound imaging technology that can diagnose blood clots in the leg veins, called deep venous thrombosis or DVT. A new or acute DVT requires emergency care. Old or chronic DVTs can damage the valves in the leg veins, causing a collection of signs and symptoms related to venous disease. We treat these types of conditions at La Jolla Vein Care.  logo-wtd-main

Deep vein thrombosis (DVT) – A blood clot that forms in the veins located deep within a limb, usually the lower leg or thigh. By blocking the flow of blood back to the heart, these clots are often characterized by pain and swelling of the leg. Clots in the leg can break off, travel to the lungs and lodge there as pulmonary embolism (PE). These can be fatal because they block the flow of blood from the lungs back into the heart.

learn more about world thrombosis day

To learn about how La Jolla Vein Care can help you, please call or email us

Sclerofill Hand Rejuvenation Procedure

The hands can show signs of aging, such as enlarged veins, thinning skin, bony appearance and age spots. Hand veins tend to appear more prominent as one ages due to decreased collagen in the skin. Hand rejuvenation procedures in the past have focused on the removal of hand veins with sclerotherapy. The new concept today is to use an injectable filler

such as Radiesse to stimulate collagen production in the hands to add volume and plump up the skin on the back of the hands, making them appear younger. Radiesse can be used alone to improve the appearance of the hands, or in combination with sclerotherapy of hand veins.

The Sclerofill procedure has been used at La Jolla Vein Care since 2012 for hand rejuvenation. This method combines sclerotherapy of prominent hand veins and the injection of a filler, such as Radiesse to stimulate collagen production. The overall result is more youthful appearing hands.

Video: Spider Vein Sclerotherapy

Watch a video on spider vein treatment with sclerotherapy.

Sclerotherapy is considered the ‘gold standard’ of treatment for leg veins

. Sclerotherapy involves an injection of a medication into the vein.  This will cause the vein to collapse and gradually fade away. Sclerotherapy has been used to treat spider veins for decades, but new solutions such as AscleraTM allow for spider veins to be treated with minimal discomfort and immediate return to activities. Saline solutions are rarely used these days by vein specialists, because alternatives solutions are less painful and better tolerated. Sclerotherapy is preferred by most vein specialists over laser because spider veins often have underlying ‘feeder veins’ that can easily be treated with sclerotherapy, but are not addressed by laser. Many people will require more than one treatment session for optimal results. The national average is 2 to 5 treatment sessions. Wearing compression stockings after treatment will improve results.

What are varicose veins and spider veins?


Spider veins are like varicose veins but smaller. Often, they are red or blue. They can look like tree branches or spiderwebs with their short, jagged lines. This patient had large clusters bluish colored spider veins around the knee (see top picture). These were treated with sclerotherapy injections at La Jolla Vein Care (after picture on bottom). To see how sclerotherapy works, go to La Jolla Vein Care’s Youtube channel.


Varicose veins are bulging, twisted veins located just under the skin. This is a before and after picture of a patient who was treated at La Jolla Vein Care with radiofrequency ablation and foam sclerotherapy to dissolve the varicose veins. There are no surgical incisions with these treatments.

Varicose (VAR-i-kos) veins are enlarged veins that can be blue, red, or flesh-colored. They often look like cords and appear twisted and bulging. They can be swollen and raised above the surface of the skin. Varicose veins are often found on the thighs, backs of the calves, or the inside of the leg. During pregnancy, varicose veins can form around the vagina and buttocks.

Spider veins are like varicose veins but smaller. They also are closer to the surface of the skin than varicose veins. Often, they are red or blue. They can look like tree branches or spiderwebs with their short, jagged lines. They can be found on the legs and face and can cover either a very small or very large area of skin.


Dr. Bunke Explains Non-surgical Varicose Vein Treatments on San Diego News

Vein Stripping is a thing of the past! Watch La Jolla Vein Care’s Dr. Bunke on San Diego Living explain alternative non-surgical vein treatments to the outdated vein stripping surgery!  The episode was aired yesterday, February 10th, on CW’s Channel 6. As Dr. Bunke explains, a common misperception about varicose vein treatment is that vein stripping surgery is still used as the main method used to treat varicose veins. The truth is, vein stripping surgery is nearly obsolete, with endovenous ablation being considered as the standard of care for treatment of the great saphenous and small saphenous veins. There are other treatment methods such as ultrasound guided foam sclerotherapy for the branching, bulging veins at the surface of the skin.

This news segment provides animations about how these vein treatments work.

For the endovenous ablation, specifically radiofrequency ablation of varicose veins, also known as the Venefit procedure (previously called VNUS Closure) is described. Dr. Bunke explains that a thin, flexible tubing called a catheter is placed inside the diseased vein. Radiofrequency energy is delivered to h
eat the vein and seal it shut. The body will gradually dissolve the treated vein. The blood is directed through other healthy veins.

A foam sclerotherapy animation is also shown. Foam sclerotherapy involves injecting a foamed medicine into the vein that will cause it to collapse, shrink and eventually dissolve.

These varicose vein procedures are minimally invasive and can be performed in the office without general anesthesia and almost immediate return to normal activities.



Spider Vein Treatment Animation

A very thin needle is used to inject a sclerosing agent along the varicose vein. Modern medicines used to inject spider veins (sclerosing agents) include polidocanol (Asclera), sodium tetradecyl sulfate (sotradecol) and glycerin. Discuss with your doctor the best type of solution for your veins.

Removing varicose and spider veins has never been easier. Click here to view a 3D animation that explains how sclerotherapy can make your veins disappear—without surgery.